NPI | 1144515180 |
---|---|
Former Name | DANA MICHELE TIBERIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WV 27589) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.123668) |
Enumeration Date | 2011-06-17 |
Last Update Date | 2018-12-10 |